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Does heart disease claim the lives of more men or women each year? Neither, experts say.

It’s about an equal split. What is greater, however, is the awareness gap, and the percentage of women who are diagnosed too late for medical intervention.

According to the American Heart Association, only 50 percent of women asked about heart disease and stroke in 2009 knew they these were a leading cause of death for women. Of these, just 13 percent said heart disease was a woman’s greatest health risk. (More women thought they should worry about breast cancer.)

Yet heart disease (including coronary heart disease, hypertension, and stroke) remains the number one cause of death in American women. It causes 1 in 3 women’s deaths each year. That adds up to over 280,000 women each year—or one woman lost to heart disease every 80 seconds. In comparison, 40,920 women in the U.S. are expected to die in 2018 from breast cancer

“Heart disease is responsible for six times as many female deaths each year than breast cancer,” says Dr. Sandra Chaparro, director of the Heart Failure/Transplant Fellowship Program at the University of Miami Health System. “Despite media campaigns, we are still trying to catch up on awareness by women. We need all women to be advocates and educators for each other,” she adds.

What are female heart disease symptoms?

A big part of the issue is women delay getting help, according to Chaparro. Their symptoms are different from symptoms experienced by men, so fewer women get diagnosed in time or are misdiagnosed.

“The classic ‘chest pain’ symptom is not as often what we need to watch for,” she offers. “Women tend to experience symptoms including shortness of breath, fatigue and even nausea. When there are symptoms of a spreading pain, it is more likely to occur in the neck, jaw or on a woman’s back.”

According to the Centers for Disease Control and Prevention, women should pay attention to symptoms including:

Heart failure: Shortness of breath, fatigue, swelling of the feet/ankles/legs/abdomen.

Stroke: Sudden weakness, paralysis (inability to move) or numbness of the face/arms/legs, especially on one side of the body. Other symptoms may include: confusion, trouble speaking or understanding speech, difficulty seeing in one or both eyes, shortness of breath, dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache.

The differences are partially related to how heart disease manifests itself in women, says Dr. Chaparro. Obstructions in female blood vessels occur less frequently in the coronary arteries. Men traditionally experience discomfort in the central chest area, because that’s where their arteries tend to be clogged.

Equal opportunity heart research

One positive step that has occurred more recently is the inclusion of women in heart disease clinical trials. For decades, the specifics of female heart disease were just not known, because only men were admitted into research studies.

“Heart disease used to be thought of as a male disease, and that was unfortunate,” shares Dr. Chaparro. “But the good news is that researchers have made and are making an aggressive, focused effort to enroll women in the latest studies. We want to continue learning more, especially for women who are at a higher risk than other women. Things like income, race, genetics and associated dietary habits, exercise or lack of, have a great impact. Those clinical research findings will allow us to improve screening guidelines, prevention strategies and treatment recommendations.”

Risk factors and prevention

If you’re a woman, be especially aware of the following risk factors for heart disease and stroke.

The good news? You can reduce your chances of getting heart disease, says Dr. Chaparro.

“Have your annual checkups each year with your doctor, and know your numbers,” she emphasizes. “Get your blood pressure checked regularly. Ask your doctor if you should be tested for diabetes. Ask for help to quit smoking, or don’t start. Eat healthier, drink less and find ways to relax and to handle stress. We can add quality years to our lives by making a double effort to prevent heart disease. The bonus is that these approaches also will prevent cancers and other diseases.”